Our Privacy Practices
Our Duty to Safeguard Your Protected Health
Information
Individually identifiable information about your
past, present, or future health or condition, the
provision of health care to you, or payment for
health care is considered “Protected Health
Information” (PHI). We are required to extend
certain protections to your PHI, and to give you
this Notice about our privacy practices that
explains how, when and why we may use or disclose
your PHI. Except in specified circumstances, we must
use or disclose only the minimum necessary PHI to
accomplish the intended purpose of the use or
disclosure. We are required to follow the privacy
practices described in this Notice though we reserve
the right to change our privacy practices and the
terms of this Notice at any time. You may request
any new notice from us.
How We May Use and Disclose Your Protected Health
Information
We use and disclose Personal Health Information for
a variety of reasons. We have a limited right to use
and/or disclose your PHI for purposes of treatment,
payment and for our health care operations. For uses
beyond that, we must have your written authorization
unless the law permits or requires us to make the
use or disclosure without your authorization. If we
disclose your PHI to an outside entity in order for
that entity to perform a function on our behalf, we
must have in place an agreement from the outside
entity that it will extend the same degree of
privacy protection to your information that we must
apply to your PHI. However, the law provides that we
are permitted to make some uses/disclosures without
your con-sent or authorization. The following
describes and offers examples of our potential
uses/disclosures of your PHI.
Uses and Disclosures Relating to Treatment,
Payment, or Health Care Operations.
Generally, we may use or disclose your PHI as
follows:
For treatment: We may disclose your PHI to
doctors, nurses, and other health care personnel who
are involved in providing your health care. For
example, your PHI will be shared among members of
your treatment team. Your PHI may also be shared
with outside entities performing ancillary services
relating to your treatment, such as for consultation
purposes, or ADAMH/CMH Boards and/or community
mental health agencies involved in the provision or
coordination of your care.
To obtain payment: We may use/disclose your
PHI in order to bill and collect payment for your
health care services. For example, we may contact
your employer to verify employment status, and/or
release portions of your PHI to the Medicaid
program, the ODMH central office, the local ADAMH/CMH
Board through the Multi-Agency Community Information
Services Information System (MACSIS), and/or a
private insurer to get paid for services that we
delivered to you. We may release information to the
Office of the Attorney General for collection
purposes.
For health care operations: We may
use/disclose your PHI in the course of operating our
Behavioral Health Program. For example, we may use
your PHI in evaluating the quality of services
provided, or disclose your PHI to our accountant or
attorney for audit purposes. Since we are an
integrated system, we may disclose your PHI to
designated support staff in our facilities, for
similar purposes. Release of your PHI to the
Multi-Agency Community Services Information System
and/or state agencies might also be necessary to
determine your eligibility for publicly funded
services.
Appointment reminders: Unless you provide us
with alternative instructions, we may send
appointment reminders and other similar materials to
your home.
Uses and Disclosures of PHI Requiring
Authorization
For uses and disclosures beyond treatment, payment
and operations purposes we are required to have your
written authorization, unless the use or disclosure
falls within one of the exceptions described below.
Authorizations can be revoked at any time to stop
future uses/disclosures except to the extent that we
have already under-taken an action in reliance upon
your authorization.
Uses and Disclosures of PHI from Mental Health
Records Not Requiring Consent or Authorization
The law provides that we may use/disclose your PHI
from mental health records without consent or
authorization in the following circumstances:
When required by law: We may disclose PHI
when a law requires that we report information about
suspected abuse, neglect or domestic violence, or
relating to suspected criminal activity, or in
response to a court order. We must also disclose PHI
to authorities that monitor compliance with these
privacy requirements.
For public health activities: We may disclose
PHI when we are required to collect information
about disease or injury, or to report vital
statistics to the public health authority.
For health oversight activities: We may
disclose PHI to our central office, the protection
and advocacy agency, or another agency responsible
for monitoring the health care system for such
purposes as reporting or investigation of unusual
incidents, and monitoring of the Medicaid program.
Relating to decedents: We may disclose PHI
related to a death to coroners, medical examiners or
funeral directors, and to organ procurement
organizations relating to organ, eye, or tissue
donations or transplants.
For research purposes: In certain
circumstances, and under supervision of a privacy
board, we may disclose PHI to internal research
staff and their designees in order to assist
medical/psychiatric research.
To avert threat to health or safety: In order
to avoid a serious threat to health or safety, we
may disclose PHI as necessary to law enforcement or
other persons who can reasonably prevent or lessen
the threat of harm.
For specific government functions: We may
disclose PHI of military personnel and veterans in
certain situations, to correctional facilities in
certain situations, to government benefit programs
relating to eligibility and enrollment, and for
national security reasons, such as protection of the
President.
Uses and Disclosures of PHI from Alcohol and
Other Drug Records Not Requiring Consent or
Authorization
The law provides that we may use/disclose your PHI
from alcohol and other drug records without consent
or authorization in the following circumstances:
When required by law: We may disclose PHI
when a law requires that we report information about
suspected child abuse and neglect, or when a crime
has been committed on the program premises or
against program personnel, or in response to a court
order.
Relating to decedents: We may disclose PHI
relating to an individual’s death if state or
federal law requires the information for collection
of vital statistics or inquiry into cause of death.
For research, audit or evaluation purposes:
In certain circumstances, we may disclose PHI for
re-search, audit or evaluation purposes.
To avert threat to health or safety: In order
to avoid a serious threat to health or safety, we
may disclose PHI to law enforcement when a threat is
made to commit a crime on the program premises or
against program personnel
Your Rights Regarding Your Protected Health
Information
You have the following rights relating to your
protected health information:
To request restrictions on uses/disclosures:
You have the right to ask that we limit how we use
or disclose your PHI. We will consider your request,
but are not legally bound to agree to the
restriction. To the extent that we do agree to any
restrictions on our use/disclosure of your PHI, we
will put the agreement in writing and abide by it
except in emergency situations. We cannot agree to
limit uses/disclosures that are required by law.
To choose how we contact you: You have the
right to ask that we send you information at an
alternative address or by an alternative means. We
must agree to your request as long as it is
reasonably easy for us to do so.
To request amendment of your PHI: If you
believe that there is a mistake or missing
information in our record of your PHI, you may
request, in writing, that we correct or add to the
record. We will respond within 60 days of receiving
your request. We may deny the re-quest if we
determine that the PHI is: (1) correct and complete;
(2) not created by us and/or not part of our
records, or; (3) not permitted to be disclosed. Any
denial will state the reasons for denial and explain
your rights to have the request and denial, along
with any statement in response that you provide,
appended to your PHI. If we approve the request for
amendment, we will change the PHI and so inform you,
and tell others that need to know about the change
in the PHI.
To find out what disclosures have been made:
You have a right to get a list of when, to whom, for
what purpose, and what content of your PHI has been
re-leased other than instances of disclosure: for
treatment, payment, and operations; to you, your
family, or the facility directory; or pursuant to
your written authorization. The list also will not
include any disclosures made for national security
purposes, to law enforcement officials or
correctional facilities, or disclosures made before
April 2003. We will respond to your written request
for such a list within 60 days of receiving it. Your
request can relate to disclosures going as far back
as six years. There will be no charge for up to one
such list each year. There may be a charge for more
frequent requests.
To inspect and request a copy your PHI:
Unless your access to your records is restricted for
clear and documented treatment reasons, you have a
right to see your protected health information upon
your written request. We will respond to your
request within 30 days. If we deny your access, we
will give you written reasons for the denial and
explain any right to have the denial reviewed. If
you want copies of your PHI, a charge for copying
may be imposed, depending on your circumstances.
You have a right to choose what portions of your
information you want copied and to have prior
information on the cost of copying.
If you have questions or concerns regarding this
information, please ask to speak with the HIPAA
privacy officer of Greenleaf Family Center.
You Have the Right to Receive this Notice
You have a right to receive a paper copy of this
Notice
How to Complain About Our Privacy Practices
If you think we may have violated your privacy
rights, or you disagree with a decision we made
about access to your PHI, you may file a complaint
with Greenleaf Family Center HIPAA Privacy Officer,
or the Client Rights Officer of Greenleaf Family
Center. You also may file a written complaint with
the Secretary of the U.S. Department of Health and
Human Services at 200 Independence Avenue SW,
Washington D.C., 20201 or call 1-877-696-6775. We
will take no retaliatory action against you if you
make such complaints.
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